Patient Selection and Outcomes of Urinary Diversion

Abstract

Urinary diversion selection depends highly on surgeon experience, patient comorbidities, operative indication, and preoperative risk assessment. Navigating this process in the setting of emerging surgical approaches, new operative technology, and evolving perioperative care plans can be difficult for general and reconstructive urologists alike. In this article, we highlight considerations for urinary diversion selection and review new updates in the literature regarding preoperative patient assessment and nutrition optimization. In addition, we review unique perioperative considerations including role of preoperative bowel prep and intraoperative maneuvers in the setting of obesity and prior radiation. Last, we examine postoperative expectations, long-term outcomes, and emerging technology to mitigate postoperative risk associated with urinary diversions.

Keywords: Ileal conduit; Intraoperative complication; Preoperative conditioning; Risk assessment; Urinary diversion.